A nurse is assessing a newborn with myelomeningocele. Which assessment finding would be the MOST concerning and require immediate intervention?

Leakage of clear fluid from the neural tube defect site indicates cerebrospinal fluid (CSF) leakage, creating a direct portal of entry for pathogens and placing the newborn at imminent risk for meningitis and ventriculitis. This requires immediate intervention: covering the site with a sterile, moist, non-adherent dressing, positioning the infant prone, and notifying the surgical team urgently. Absence of deep tendon reflexes with flaccid paralysis and inability to move the lower extremities are expected baseline deficits related to the level of the lesion, and a single head circumference at the 95th percentile suggests developing hydrocephalus that requires monitoring but is less immediately life-threatening than an open CSF leak.